There are currently over one million people in the UK suffering with severe and complex obesity (defined by NICE as a BMI of over 40 or between 35 and 40 if suffering from other significant disease) and the management of this obesity epidemic is currently costing the NHS around £4.2 billion, with indirect healthcare and societal costs estimated at around £16 billion; figures which have been predicted to more than double by 2050.
When the National Institute for Health and Clinical Excellence (NICE) first reported on the benefits and value for money of obesity surgery eight years ago, less was known about the dramatic effects of such surgery on associated co-morbidities such as diabetes, sleep apnoea and even cancer.
We now know that bariatric surgery not only has the capacity to induce major weight loss in the long term, but also ‘cure’ diabetes in 84% of cases, sometimes within days, resulting in patients no longer needing costly treatments with drugs such as insulin. Sleep apnoea syndrome - thought to account for 300 deaths on the road each year where patients fall asleep at the wheel – enters remission, and over a seven year period, cancer death rate is halved in patients who have had surgery compared to those who did not.
Even with a rapid expansion of surgical services across the UK, ESCO highlights today that not all patients who are eligible and willing to undergo surgery will be able to receive treatment. There are currently 230,000 people who are eligible under the NICE guidelines and willing to have the surgery in the UK, yet this year only 6,000 patients will actually receive surgical treatment.
Dr Carel Le Roux, warns; “Weight loss surgery is not ,as many people believe, an ‘easy option’ or ‘quick fix’ for patients. In some ways the surgery makes patients’ lives much harder than before as they have to make lifestyle changes that require many adjustments and a great deal of support. In treating the associated chronic illnesses, weight loss surgery helps to make people healthier and more functional, while dramatically reducing the need for and cost of healthcare provision.”
